Screening for Gonorrhea and Chlamydia by DNA Amplification in Adolescents Attending Middle School Health Centers

Abstract

Goal: To determine prevalence and incidence ofNeisseria gonorrhoeae(GC) andChlamydia trachomatis(CT) infection and assess risk factors predictive for such infections in a middle school-based clinic sample. Study Design: 170 female students and 43 male students making 256 and 47 visits, respectively, ≥ 30 days apart, in urban middle school clinics for primary care screening, reproductive health, or illness/injury were routinely asked to provide urine specimens for GC and CT ligase chain reaction testing if sexually active in the preceding 3-month period. Information regarding prior sexually transmitted diseases, reason for visit, and sexual risk behaviors was obtained. Results: GC: 11.4% of female student and 2.1% of male student tests were positive. Incidence was 34.0 cases/1,000 person months(95% Confidence interval [CI]: 19.5-67.5). Median time tofirstpositive andrepeatpositive test was 4.6 and 2.6 months, respectively. For CT: 16.4 % of female student and 2.1% of male student tests were positive. Incidence was 57.5 cases/1,000 person months (95% CI: 35.2-93.8). Median time tofirstpositive andrepeatpositive CT test was 6.0 and 4.8 months, respectively. Assessed risk factors failed to specify a candidate screening population. Conclusion: These data suggest that all sexually active adolescent girls in this high risk setting should be offered testing for GC and CT at least twice per year, regardless of age or other sexual risk behaviors and that STD control efforts in high risk middle schools should be encouraged.